Abstract 4246: Dobutamine-induced Reserve of the Two-dimensional Longitudinal Strain Rate Predicts Clinical and Neurohumoral Improvement After Levosimendan Treatment in Acutely Decompensated Chronic Heart Failure

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Vasiliki Bistola ◽  
Ioannis Paraskevaidis ◽  
Ignatios Ikonomidis ◽  
Ioannis Parissis ◽  
Gerasimos Filippatos ◽  
...  
Keyword(s):  
Strain Rate ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Nyha Class ◽  
Radial Strain ◽  
Left Ventricular ◽  
Contractile Reserve ◽  
Systolic Strain ◽  
Strain And Strain Rate ◽  
Longitudinal Strain Rate

Objective: Levosimendan improves symptoms and the hemodynamic profile in patients with acutely decompensated chronic heart failure (ADCHF). We aimed to investigate: the association of low dose dobutamine (DSE)-induced changes of two-dimensional strain parameters with the corresponding changes of left ventricular ejection fraction (LVEF) and left ventricular outflow tract velocity time integral (LVOT VTI) in patients with ADCHF, and whether left ventricular contractile reserve assessed by both conventional and speckle tracking echocardiography is associated with clinical and neurohumoral improvement after levosimendan treatment. Methods: Thirty one consecutive patients with ADCHF (mean age 65 ± 10 years, NYHA class 3.6 ± 0.3, LVEF 22 ± 6%) were studied by DSE (peak dose 20 μg/kg/min) prior to 24-hour infusion of levosimendan (0.01 μg/kg/min, without bolus). The LVEF, LVOT VTI, mean longitudinal, circumferential and radial strain and strain rate using speckle tracking imaging were measured. Results: Twenty-three patients (74%) had evidence of contractile reserve (increase of LVEF > 10% and LVOT VTI > 20% after peak dobutamine dose, CR+), and 8 (26%) showed no reserve (CR−). CR+ versus CR- patients demonstrated greater improvement of NYHA class (mean NYHA change: −1.0±0.5 vs −0.5±0.3 NYHA class, p=0.01), and reduction of b-type natriuretic peptide levels (− 34±30 vs + 4±31%, p <0.01) 48 hours after completion of treatment. By multivariate analysis, mean longitudinal systolic strain rate reserve (resting - peak longitudinal strain rate ΔLSR (%)) was the best predictor of improvement of NYHA class (p= 0.039) and BNP (p= 0.042) after levosimendan administration among the reserve of: LV FS, EF, LVOT VTI, longitudinal strain, circumferential and radial strain and strain rate. Conclusion: Dobutamine-induced reserve of 2-dimentional speckle tracking longitudinal systolic strain rate is associated with clinical and neurohumoral improvement after treatment with levosimendan in patients with ADCHF.

scholarly journals Left ventricular systolic function impairment in children after balloon valvuloplasty for congenital aortic stenosis assessed by 2D speckle tracking echocardiography

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0248862
Author(s):  
Krzysztof Godlewski ◽  
Paweł Dryżek ◽  
Elżbieta Sadurska ◽  
Bożena Werner
Keyword(s):  
Strain Rate ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Circumferential Strain ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Strain And Strain Rate ◽  
Eccentric Hypertrophy

Aims The aim of the study was to evaluate left ventricular (LV) remodeling and systolic function using two-dimensional speckle tracking echocardiographic (2D STE) imaging in children at a long-term (more than 36 months, 107.5±57.8 months) after balloon valvuloplasty for aortic stenosis (BAV). Methods and results 40 patients (mean age 9,68 years, 75% male) after BAV and 62 control subjects matched to the age and heart rate were prospectively evaluated. The 2D STE assessment of LV longitudinal and circumferential strain and strain rate was performed. Left ventricular eccentric hypertrophy (LVEH) was diagnosed in 75% of patients in the study group. Left ventricular ejection fraction (LVEF) was normal in all patients. In study group, global longitudinal strain (GLS), global longitudinal strain rate (GLSr) were significantly lower compared with the controls: GLS (-19.7±2.22% vs. -22.3±1.5%, P< 0.001), GLSr (-0.89±0.15/s vs. -1.04 ±0.12/s, P < 0.001). Regional (basal, middle and apical segments) strain and strain rate were also lower compared with control group. Global circumferential strain (GCS), global circumferential strain rate (GCSr) as well as regional (basal, middle and apical segments) strain and strain rate were normal. Multivariable logistic regression analysis included: instantaneous peak systolic Doppler gradient across aortic valve (PGmax), grade of aortic regurgitation (AR), left ventricular mass index (LVMI), left ventricular relative wall thickness (LVRWT), left ventricular end-diastolic diameter (LVEDd), peak systolic mitral annular velocity of the septal and lateral corner (S’spt, S’lat), LVEF before BAV and time after BAV and showed that the only predictor of reduced GLS was LV eccentric hypertrophy [odds ratio 6.9; (95% CI: 1.37–12.5), P = 0.045]. Conclusion Patients at long-term observation after BAV present the subclinical LV systolic impairment, which is associated with the presence of its remodeling. Longitudinal deformation is the most sensitive marker of LV systolic impairment in this group of patients.

scholarly journals High-frequency speckle tracking echocardiography in the assessment of left ventricular function and remodeling after murine myocardial infarction

2014 ◽  
Vol 306 (9) ◽  
pp. H1371-H1383 ◽  
Author(s):  
Amit Bhan ◽  
Alexander Sirker ◽  
Juqian Zhang ◽  
Andrea Protti ◽  
Norman Catibog ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Infarct Size ◽  
Strain Rate ◽  
High Frequency ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Radial Strain ◽  
Left Ventricular ◽  
Intraobserver Variability ◽  
Strain And Strain Rate

The objectives of this study were to assess the feasibility and accuracy of high-frequency speckle tracking echocardiography (STE) in a murine model of myocardial infarction (MI). STE is used clinically to quantify global and regional cardiac function, but its application in mice is challenging because of the small cardiac size and rapid heart rates. A high-frequency microultrasound system with STE (Visualsonics Vevo 2100) was compared against magnetic resonance imaging (MRI) for the assessment of global left ventricular (LV) size and function after murine MI. Animals subjected to coronary ligation ( n = 46) or sham ligation ( n = 27) were studied 4 wk postoperatively. Regional and global deformation were also assessed. STE-derived LV ejection fraction (EF) and mass correlated well with MRI indexes ( r = 0.93, 0.77, respectively; P < 0.001), as did STE-derived mass with postmortem values ( r = 0.80, P < 0.001). Higher STE-derived volumes correlated positively with MRI-derived infarct size ( P < 0.01). Global strain parameters were significantly reduced after MI (all P < 0.001) and strongly correlated with LV mass and MRI-derived infarct size as promising surrogates for the extent of remodeling and infarction, respectively (both P < 0.05). Regional strain analyses showed that radial strain and strain rate were relatively preserved in anterior basal segments after MI compared with more apical segments ( P < 0.001); however, longitudinal strain and strain rate were significantly impaired both basally and distally ( P < 0.001). Strain-derived parameters of dyssynchrony were significantly increased in the MI group ( P < 0.01). Analysis time for STE was 210 ± 45 s with acceptable inter- and intraobserver variability. In conclusion, high-frequency STE enables quantitative assessment of regional and global function in the remodeling murine LV after MI.

scholarly journals Echocardiographic evaluation of left ventricle mechanical parameters in infants of the first year of life

2017 ◽  
Vol 21 (3) ◽  
pp. 23
Author(s):  
Yu. S. Sinelnikov ◽  
E. N. Orekhova ◽  
T. V. Matanovskaya ◽  
M. A. Polevshikova
Keyword(s):  
Left Ventricle ◽  
Strain Rate ◽  
Conflict Of Interest ◽  
Longitudinal Strain ◽  
Radial Strain ◽  
Left Ventricular ◽  
First Year ◽  
Strain And Strain Rate ◽  
Healthy Infants ◽  
First Year Of Life

<p><strong>Aim.</strong> The study focused on the analysis of the measurement range of left ventricle mechanics (strain, strain rate, rotation, rotation rate, twisting, untwisting, torsion) in healthy infants of the first year of life to obtain their baseline values.<br /><strong>Methods.</strong> The study included 125 healthy infants aged 5 days to 12 months (average 5.9±3.9 months. The Аcuson S 2000 machine (Siemens Medical Systems, Mountain View, CA, USA) was used to perform echocardiography. The indicators of left ventricle longitudinal strain (%) and strain rate (s–1), radial strain and strain rate (% and s–1), circumferential strain and strain rate (% and s–1), basal and apical rotation in systole and diastole (°) and rotation rate (°/s), twisting (°), untwisting (°), twisting and unwinding rate (°/s) and torsion (°/cm) were measured and analyzed. <br /><strong>Results</strong>. It was found out that the values of the longitudinal strain and strain rate inversely correlate with the pumping function (stroke volume index) and diastolic function (filling pressures and the untwisting rate). The parameters of the circular and radial strain tended to depend on the left ventricle mass index, interventricular septum/left ventricle posterior wall thicknesses. Left ventricle twisting and untwisting would increase in healthy infants from the newborn period to the first year of life. Left ventricle torsion range was determined by the twist values and not by left ventricular geometry.<br /><strong>Conclusion.</strong> The obtained data on the values of longitudinal, circumferential and radial left ventricle strain and strain rate can be used as reference ranges to evaluate the mechanical left ventricular function in infants of the first year of life.</p><p>Received 27 January 2017. Accepted 15 June 2017.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> The authors declare no conflict of interest.</p><p><strong>Author contributions</strong><br />Conception and study design: Yu.S. Sinelnikov, E.N. Orekhova<br />Data collection and analysis: M.A. Polevshikova, T.V. Matanovskaya <br />Drafting the article: E.N. Orekhova, M.A. Polevshikova<br />Critical revision of the article: Yu.S. Sinelnikov, E.N. Orekhova<br />Final approval of the version to be published: Yu.S. Sinelnikov, E.N. Orekhova, T.V. Matanovskaya, M.A. Polevshikova</p>

Deformation echocardiography

2016 ◽  
Author(s):  
Matteo Cameli ◽  
Partho Sengupta ◽  
Thor Edvardsen
Keyword(s):  
Strain Rate ◽  
Tissue Doppler Imaging ◽  
Speckle Tracking ◽  
Radial Strain ◽  
Tissue Doppler ◽  
Strain Imaging ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Deformation Imaging ◽  
Strain And Strain Rate

Echocardiographic strain imaging, also known as deformation imaging, has been developed as a means to objectively quantify regional and global myocardial function. First introduced as a post-processing feature of tissue Doppler imaging velocity converted to strain and strain rate, strain imaging has more recently also been derived from speckle tracking analysis. Tissue Doppler imaging yields velocity information from which strain and strain rate are mathematically derived whereas two-dimensional speckle tracking yields strain information from which strain rate and velocity data are derived. Data obtained from these two different techniques may not be equivalent due to limitations inherent with each technique. Speckle tracking analysis can generate longitudinal, circumferential, and radial strain measurements and left ventricular twist. Although potentially useful, these measurements are also complicated and frequently displayed as difficult-to-interpret waveforms. Strain imaging is now considered a robust research tool and has great potential to play many roles in routine clinical practice. This chapter explains the fundamental concepts of deformation imaging, the technical features of strain imaging using tissue Doppler imaging and speckle tracking, and the strengths and weaknesses of these methods.

scholarly journals The influence of acute unloading on left ventricular strain and strain rate by speckle tracking echocardiography in a porcine model

2016 ◽  
Vol 310 (10) ◽  
pp. H1330-H1339 ◽  
Author(s):  
Geir Olav Dahle ◽  
Lodve Stangeland ◽  
Christian Arvei Moen ◽  
Pirjo-Riitta Salminen ◽  
Rune Haaverstad ◽  
...  
Keyword(s):  
Strain Rate ◽  
Speckle Tracking ◽  
Circumferential Strain ◽  
Speckle Tracking Echocardiography ◽  
Radial Strain ◽  
Left Ventricular ◽  
Conductance Catheter ◽  
Left Ventricular Strain ◽  
End Diastolic Volume ◽  
Strain And Strain Rate

Noninvasive measurements of myocardial strain and strain rate by speckle tracking echocardiography correlate to cardiac contractile state but also to load, which may weaken their value as indices of inotropy. In a porcine model, we investigated the influence of acute dynamic preload reductions on left ventricular strain and strain rate and their relation to the pressure-conductance catheter-derived preload recruitable stroke work (PRSW) and peak positive first derivative of left ventricular pressure (LV-dP/d tmax). Speckle tracking strain and strain rate in the longitudinal, circumferential, and radial directions were measured during acute dynamic reductions of end-diastolic volume during three different myocardial inotropic states. Both strain and strain rate were sensitive to unloading of the left ventricle ( P < 0.001), but the load dependency for strain rate was modest compared with strain. Changes in longitudinal and circumferential strain correlated more strongly to changes in end-diastolic volume ( r = −0.86 and r = −0.72) than did radial strain ( r = 0.35). Longitudinal, circumferential, and radial strain significantly correlated with LV-dP/d tmax ( r = −0.53, r = −0.46, and r = 0.86), whereas only radial strain correlated with PRSW ( r = 0.55). Strain rate in the longitudinal, circumferential and radial direction significantly correlated with both PRSW ( r = −0.64, r = −0.58, and r = 0.74) and LV-dP/d tmax ( r = −0.95, r = −0.70, and r = 0.85). In conclusion, the speckle tracking echocardiography-derived strain rate is more robust to dynamic ventricular unloading than strain. Longitudinal and circumferential strain could not predict load-independent contractility. Strain rates, and especially in the radial direction, are good predictors of preload-independent inotropic markers derived from conductance catheter.

scholarly journals Assessment of Longitudinal Left Ventricle Deformation by 2-Dimensional Speckle Tracking Echocardiography Obtained from Different Views in Cats

2020 ◽  
Vol 7 (3) ◽  
pp. 104
Author(s):  
Domenico Caivano ◽  
Mark Rishniw ◽  
Lucia Baiona ◽  
Francesco Birettoni ◽  
Noemi Nisini ◽  
...  
Keyword(s):  
Strain Rate ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Left Ventricular ◽  
Deformation Analysis ◽  
Longitudinal Deformation ◽  
Limits Of Agreement ◽  
Measurement Variability ◽  
Strain And Strain Rate

Two-dimensional speckle tracking echocardiography (STE) is a novel, angle-independent imaging technique useful to assess myocardial function by strain and strain rate analysis in human and veterinary medicine. Commonly, the left apical four-chamber (LAP4Ch) view is used to assess left ventricular (LV) longitudinal deformation in dogs and cats. However, the right parasternal four-chamber (RP4Ch) view is often more easily obtained than the LAP4Ch view in cats. No studies exist comparing longitudinal strain and strain rate values using STE from different echocardiographic views in cats. Therefore, we examined the agreement between RP4Ch and LAP4Ch for assessment of LV longitudinal strain and strain rate in cats. We acquired 2D echocardiographic cineloops from RP4Ch and LAP4Ch views and analyzed LV longitudinal strain and strain rate in 50 cats (31 healthy cats and 19 cats with different disease states) using XstrainTM software. Peak systolic strain and strain rate values of endocardial and epicardial border were used for the analysis. The two echocardiographic views were compared using limits-of-agreement analyses and intra-observer measurement variability was assessed. We could obtain longitudinal strain and strain rate from the RP4Ch view in all cats. Strain, but not strain rate, had good intra-observer measurement variability (<10% vs. <20%). However, only endocardial strain values obtained with the two views agreed sufficiently to be used interchangeably (95% limits of agreement: −3.28, 2.58). Epicardial strain/strain rate and endocardial strain rate values did not agree sufficiently to be used interchangeably (95% limits of agreement: −11.58, 9.19; −2.28, 1.74; −1.41, 1.36, respectively). Our study suggests that RP4Ch view was feasible for assessment of the LV longitudinal deformation analysis by STE in cats, but only endocardial longitudinal strain values obtained from the two different views were interchangeable.

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